THE IMPACT OF ADS CLOSURES DURING COVID-19 ON PERSONS WITH DEMENTIA AND THEIR CAREGIVER

Abstract Due to the COVID-19 pandemic, many Adult Day Services (ADS), community-based programs that provide supervision, social support, and/or assistance with daily activities for clients, either temporarily or permanently terminated in-person services. Such closures left vulnerable older adults with dementia without vital services. To date, there is limited information exploring the nuances and impact of ADS closures on individuals with dementia and their care providers. To address this knowledge gap, data were drawn from an interview-based NIH-funded protocol that evaluated the experiences of informal and formal dementia care providers during the height of the COVID-19 pandemic. Data were filtered by the subsample (n=25) who provided care to an individual with dementia who participated in an ADS program. Analysis focused on all data coded “ADS,” which encompassed discussion pertaining to adult day programming. Content analyses indicated a range of themes including 1.accelerated cognitive and psychological decline, 2.engaging is precarious conduct, 3.increased caregiver burden (financial, physical, emotional), and 4.premature transitions to institutional care settings. Despite well intentioned efforts to shield the older adult population from harmful exposures during the height of the pandemic, ADS closures (both permanent and temporary) negatively impacted the health and welfare of an already vulnerable population and their caregivers. Findings add to the ongoing literature suggesting ADS and analogous supports should be classified as essential services and not face closure mandates during similar public health emergencies.

interpretive descriptive approach.Participants (n=15) were mostly female (n=13), adult children (n=8), and the majority (n=9) had a PACT experience during the Covid-19 pandemic.Family caregivers reported improved engagement with the PwD and healthcare team in the acute care setting, because hospital policies on Covid-19 allowed one visitor which gave family caregivers the option to be physically present and advocate for the PwD.However, after the PACT, only essential workers were allowed at the skilled nursing facility making it impossible for family caregivers to visit the PwD and communicate with professional caregivers.Lack of perceived support negatively affected family caregivers' ability to communicate, share knowledge, advocate, and participate in critical decision making.These Covid-19 challenges highlight the importance of being physically present as a necessary component to engagement which was a form of communication compensation that improves outcomes for the PwD.Future practice policies should view family caregivers as essential to the healthcare team and develop innovative solutions to connect family caregivers to the PwD during Covid-19 or future pandemics.

SINGING WITH DEMENTIA: CREATING AND PILOT TESTING A VIDEO TO CHANGE ATTITUDES OF MEDICAL RESIDENTS
Jody Sharninghausen 1 , Carrie Ann Davison 1 , and Richard Marottoli 2 , 1. Yale School of Medicine,New Haven,Connecticut,United States,2. Yale Medical School,New Haven,Connecticut,United States As part of the "Creativity in Aging" project at Yale Geriatrics, we are making a series of short videos highlighting individuals and programs that transcend dementia through music.The target audience includes health trainees and professionals who care for older adults.The first video, made by a PhD candidate and an internal medicine resident physician, features The Recollections: a chorus of community dwelling people with dementia, their caregivers, and college students.Video learning objectives are to 1) change dementia attitudes; 2) demonstrate preserved skills and abilities of persons with dementia; and 3) raise awareness about local initiatives for music in dementia and how to refer patients.We interviewed the chorus founder, a geriatric psychiatrist, who described the creative process, including logistics and vision, and provided advice to caregivers and medical residents.Live clips from chorus rehearsals were shown, including singing and dancing, with voiceovers describing participant stories.Slides reinforced key points.The video was pilot tested on a group of residents from the Internal Medicine and Psychiatry programs.All respondents (N=6) used positive words such as "optimistic" and "inspired" to describe how the video made them feel.Most indicated it was moderately relevant to their care of patients with dementia and several provided suggestions on how to increase relevance.Constructive feedback included parts to compress or expand, overall length, visual aspects, and desire for more 'how to' guidance.Future plans include sharing a revised version with the broader residency program with pre-andpost dementia attitudes surveys.

SOCIOECONOMIC FACTORS AND LATER LIFE OUTCOMES IN UNEXPECTED DEMENTIA TRAJECTORIES
Yulin Yang 1 , and Elizabeth Luth 2 , 1. University of California,San Francisco,San Francsico,California,United States,2. Rutgers University,New Brunswick,New Jersey,United States Dementia's uncertain trajectory may complicate its relationship with social determinants of health-race, ethnicity, socioeconomic status-and put individuals who experience unexpected dementia trajectories (e.g., probable dementia at one point, no dementia at a future point) at increased risk of poorer outcomes.This study identifies dementia trajectories in longitudinal survey data, their association with socio-economic factors, and their relationship with later life outcomes.We analyzed weighted data for 9740 adults aged 65+ participating in ≥3 waves of the 2004-2016 Health and Retirement Study.After identifying 5 dementia trajectory patterns, we analyzed the association between sociodemographic factors and dementia trajectories using multinomial logistic regression.We analyzed the relationship between dementia trajectories, socio-economic factors, and three later life outcomes (hospitalization, nursing home admission, and advance care planning) using logistic and multinomial logistic regression.A small percentage (2.2%) of respondents reported an unexpected dementia trajectory.African American and Hispanic respondents and those with lower socioeconomic status had increased risk of unexpected dementia trajectories (vs.no dementia) (e.g., African American RRR: 3.67, 95%CI: 2.30-5.86,p= 0.000; Hispanic RRR: 1.89, 95%CI 1.08-3.30,p=0.26).Older adults with unexpected dementia trajectories had increased risk of nursing home admission (RRR: 4.13, 95%CI: 1.53-11.16,p=0.005), but not hospitalization or advance care planning.Policy and measurement development should proactively address systemic inequities linked to race, ethnicity and socioeconomic status that emerge in and result from dementia trajectory assessments and lived experiences.Interventions should attend to the needs of individuals with unexpected dementia trajectories with respect to institutionalization.

THE IMPACT OF ADS CLOSURES DURING COVID-19 ON PERSONS WITH DEMENTIA AND THEIR CAREGIVER
Laura Girling 1 , and Gretchen Tucker 2 , 1. Towson, Towson, Maryland, United States, 2. University of Maryland, Baltimore, Baltimore, Maryland, United States Due to the COVID-19 pandemic, many Adult Day Services (ADS), community-based programs that provide supervision, social support, and/or assistance with daily activities for clients, either temporarily or permanently terminated in-person services.Such closures left vulnerable older adults with dementia without vital services.To date, there is limited information exploring the nuances and impact of ADS closures on individuals with dementia and their care providers.To address this knowledge gap, data were drawn from an interview-based NIH-funded protocol that evaluated the experiences of informal and formal dementia care providers during the height of the COVID-19 pandemic.Data were filtered by the subsample (n=25) who provided care to an individual with dementia who participated in an ADS program.Analysis focused on all data coded "ADS," which encompassed discussion pertaining to adult day programming.Content analyses indicated a range of themes including 1.accelerated cognitive and psychological decline, 2.engaging is precarious conduct, 3.increased caregiver burden (financial, physical, emotional), and 4.premature transitions to institutional care settings.Despite well intentioned efforts to shield the older adult population from harmful exposures during the height of the pandemic, ADS closures (both permanent and temporary) negatively impacted the health and welfare of an already vulnerable population and their caregivers.Findings add to the ongoing literature suggesting ADS and analogous supports should be classified as essential services and not face closure mandates during similar public health emergencies.
Zhirui Chen 1 , and Zhen Cong 1 , 1.The University of Alabama at Birmingham, Birmingham, Alabama, United States This study examined how older adults differed from their younger counterparts in psychological distress following exposures to tornadoes and the COVID-19 pandemic; and how the multidimensional negative COVID-19 impacts contextualized the above age differences.Data used were from a two-wave panel study of tornado victims during the COVID-19 pandemic (N = 554).Latent class analysis was first conducted to explore the underlying patterns of negative COVID-19 impacts at T1 (October 2020-August 2021).Negative binomial regressions were performed to examine the age differences in psychological distress at T2 (May-August 2022), as well as the moderating effect of the identified latent classes, with baseline psychological distress and covariates controlled.Three latent classes were identified: class 1 "low overall impacts" (39.24%), class 2 "moderate overall impacts with high emotional distress" (47.71%), and class 3 "severe overall impacts" (13.05%).Individuals aged 65+ reported lower psychological distress at T1 relative to those aged 18-34, 35-49, and 50-64, and their advantages in mental health over people under 50 can be maintained over time.However, compared to people aged 18-34, 35-49, and 50-64, those aged 65+ reported the greatest increases in T2 psychological distress if they had experienced moderate or severe overall COVID-19 impacts at T1.These findings highlighted the resilience and vulnerability of older adults in post-disaster recovery.As the frequency and intensity of cumulative disasters increase across the globe, there is a pressing need for mental health interventions that are tailored to multi-disaster scenarios and age-related differences in long-term disaster recovery.Secondary control beliefs (e.g., "negative experiences can be blessings in disguise") reflect a psychological resource that can protect well-being for individuals who encounter uncontrollable life circumstances.However, previous research has focused on between-person differences in secondary control; little is known about the role of dynamic, within-person shifts in secondary control during major life stressors such as the COVID-19 pandemic.Our study examined whether withinperson changes in secondary control beliefs were associated with corresponding within-person shifts in mental health and well-being during the pandemic.We analyzed 1-year data from the NDSU National COVID Study which contains 4 waves of data from a nationally representative sample of U.S. adults aged 18-80 (n = 293).Multilevel models assessed the extent to which within-person shifts in secondary control predicted corresponding changes in mental health (perceived stress, depressive symptoms), hedonic well-being (positive and negative affect, life satisfaction), and eudemonic well-being (personal growth, meaning and purpose).All models controlled for age, sex, education, income, and between-person differences in secondary control.Within-person changes in